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TOXICOLOGY > Skin > Flashcards

Skin Flashcards

1
Q

why do you need to reappl suncreen

A

P450 enzymes in teh skin can degrade it

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2
Q

clinical manifestation of contact dermatitis

A

erythema
induration (thick)
scaling
vesiculation

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3
Q

irritant contant dermatitis due to

A

not immunologic

depends on dose applied

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4
Q

characteristics of irritant contact derm

A

pink to red patches or plaques
blisters
itching
michenification (epidermal thickening)

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5
Q

allergic contact dermatitis due to

A

delayed type4 hypersensitivity reaction
first exposure creates antigen on second exposure presents the antigen to t cells that are now sensitized and activates immune response

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6
Q

when does allergic contact dermititis occur

A

within 12 hr of sensitization

peaks 48-72 hr

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7
Q

contact urticaria due to

A

IgE mediated

histamine release

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8
Q

presentation of contact urticaria

A

transient
pruritic
edematous
pink papules or wheals

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9
Q

protective agents from Uv radiation

A

melanin and amino acids

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10
Q

what is photosensitivity

A

abnormal sensitivity to UV and visible light due to endogenous or exogenous factors

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11
Q

difference between phototoxicity and photoallergy

A

toxicity due to activation of certain compounds due to light and can occur at first exposure and allergy is the generation of antigen activation

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12
Q

what is phototxicity

A

occurs at first exposure

chemicals from meds absorb UV light and reach higher energy excited state

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13
Q

acute phototoxicity reaction

A

skin red
blister within minutes to hours after light exposure
basically a sunburn

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14
Q

chronic phototoxicity skin reaction

A

hyperpigmentation - spots

thickening

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15
Q

drugs causing phototoxicity

A

amiodarone

flouroquinolone

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16
Q

what is photoallergy

A

type 4 delayed hypersensitivity requires prior sensitization

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17
Q

uv light role in photoallergy

A

necessary to convert a potential photosensitizing chemical into a hapten that binds to a tissue antigen = allergic response at next exposure

18
Q

presentation of maculopapular eruptions

A

morbilliform
start on trunk adn spread to entire body
flat or raised red lesion
symmetrical
itchy macules and papules
small red spots that are itchy and raised

19
Q

when does maculopapular eruptions occur

A

appear within first week of therapy

common in amox

20
Q

clinical presentation or urticaria

A

pink or red raised papules and plaques
localized vasodilation adn transudation of fluid from small cutaneous blood vessels
angioedema due to vasodilation
large, more red

21
Q

mechanism of urticaria

A

type 1 (IgE)
type 3
direct effects on mast cells
inhibition of prostaglandins

22
Q

fixed drug eruption presentation

A

bright dusky red
oval or circular patch with central pigmentation
blister
sometimes burning

23
Q

where do fixed drug eruptions occur

A

at the same sites on reapeated admin of drug

face hands feet mouth

24
Q

when does fixed drug eruptions heal

A

7-20 days after discontinuing

25
Q

erythema multiforme caused by

A

type 3 immune reaction

26
Q

erythema multiforme presents as

A

red maculae that become edematous and papular

concentric rings of different color : red, purple, white, black

27
Q

common sites of erythema multiforme

A

face
hands
limbs
mucous membranes

28
Q

what is SJS

A

severe varient of erythema multiforme

29
Q

SJS presentation

A 
mucosal and conjunctival edema
erosions
fever
myalgia
vomiting
diarrhea
arthralgia 
skin lesions severe with denudation (detach from body)
30
Q

complications of SJS

A 
keratitis
conjunctival scarring
blindness
pneumonia
dehydration
esophagitis
31
Q

drug causes of SJS

A

ibuprofen
penicillin
salyicylate
also some genetic predisposition but unclear

32
Q

severity of TEN

A

life threatening high mortality rates

33
Q

clinical manifestations of TEN

A

prodromal: malaise, sore throat, headache, myalgia, fever, cough
acute onset of cutanoues manifestations within hours or days
macular lesion with burning sensation that enlarges over the body
large blister with redness
detachment of epidermis (necrosis)

34
Q

areas effected by TENs

A 
palms
soles
mouth 
throat
nose
trachea
eyelid
cornea
conjunctiva
35
Q

complications of TEN

A 
similar to second degree burns
fluid adn electrolyte disorder
septicemia
pneumonia
hepatocellular damage
GI ulcer
nephritis
myocardial damage
36
Q

mechanism of TEN

A

cytotoxic intermediates produced during metabolism of carbamaxepine
immunologic
metabolic

37
Q

what is erythema nodosum

A

inflammatory reaction of the SC fat

creates dark nodules

38
Q

presentation of drug induced lupus erythematosus

A

red rash on face in the form of a butterfly
fever malaise
arthritis

39
Q

what is purpura

A

bleeding into the skin

40
Q

causes of purpura

A

drugs that interfere with platelet aggregation or coagulation
cytotoxic drugs
direct endothelial damage (bleomycin)

41
Q

causes of hyperpigmentation

A

deposit of melanin in the dermis or stimulation of melanin production
amiodarone
oral contraceptive

TOXICOLOGY (24 decks)

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